The results of treatment of 82 patients with chronic laryngeal stenosis during a 20-year period are presented. Road traffic accidents accounted for 30% of the cases and iatrogenic disease for 40%. Of the stenoses 10% were supraglottic, 20% glottic, 50% subglottic, and 15% combined. Virtually all patients with supraglottic stenosis had a good result as regards voice and airway, and we describe the use of a laryngeal widening operation for this group of patients. Over 80% of patients with glottic stenosis achieved good results. However, patients with a subglottic stenosis did badly, and only 60% were relieved of their tracheostomies. Patients with stenosis due to previous tracheostomy or to systemic disease such as Wegener's granuloma did badly.
There has been no standardization of clinical assessment of the nasal airway between different clinical trials. In order to evaluate the reproducibility of tests in use in current clinical practice, a pre-trial inter-observer assessment of the nasal airway tests was made and an intra- and inter-observer assessment was made in 25 patients. Differing degrees of correlation were demonstrated, using the Kappa statistic. Suggestions are made to enable improved standardization of clinical examination of the nasal airways for clinical trials.
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